Remote self-report and speech-in-noise measures predict clinical audiometric thresholds

Abstract

Objective

Developments in smartphone technology and the COVID-19 pandemic have highlighted the feasibility and need for remote, but reliable hearing tests. Previous studies used remote testing but did not directly compare results in the same listeners with standard lab or clinic testing. This study investigated validity and reliability of remote, self-administered digits-in-noise (remote-DIN) compared with lab-based, supervised (lab-DIN) testing. Predictive validity was further examined in relation to a commonly used self-report, Speech, Spatial, and Qualities of Hearing (SSQ-12), and lab-based, pure tone audiometry.

Design

DIN speech reception thresholds (SRTs) of adults (18-64 y/o) with normal hearing (NH, N = 16) and hearing loss (HL, N = 18), were measured using English-language digits (0-9), binaurally presented as triplets in one of four speech-shaped noise maskers (broadband, low-pass filtered at 2, 4, 8 kHz) and two phases (diotic, antiphasic).

Results

High, significant intraclass correlation coefficients indicated strong internal consistency of remote-DIN SRTs, which also correlated significantly with lab-DIN SRTs. There was no significant mean difference between remote- and lab-DIN on any tests. NH listeners had significantly higher SSQ scores and remote- and lab-DIN SRTs than listeners with HL. All versions of remote-DIN SRTs correlated significantly with pure-tone-average (PTA), with the 2-kHz filtered test being the best predictor, explaining 50% of the variance in PTA. SSQ total score also significantly and independently predicted PTA (17% of variance) and all test versions of the remote-DIN, except the antiphasic BB test.

Conclusions

This study underscores the effectiveness of remote DIN test and SSQ-12 in assessing auditory function. These findings suggest the potential for wider access to reliable hearing assessment, particularly in remote or underserved communities.

Keywords:

• Tele-audiology
• speech perception in noise
• hearing loss
• digits-in-noise
• SSQ

Author’s contribution

L.M.Z., D.W.S and D.R.M. designed the experiments. L.M.Z. and V.B. collected the data. L.M.Z. and L.L. analyzed the data. L.M.Z., D.R.M and D.W.S. wrote the manuscript. D.W.S. and D.R.M. have a relationship with the hearX Group that includes equity, consulting, and potential royalties.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by National Institution of Health(NIH) grant R21DC016241 and by the Cincinnati Children’s Research Foundation. David Moore receives support from the NIHR Manchester Biomedical Research Centre.